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Obesity and Critical Illness in COVID-19: Respiratory Pathophysiology.
Wolf, Molly; Alladina, Jehan; Navarrete-Welton, Allison; Shoults, Benjamin; Brait, Kelsey; Ziehr, David; Malhotra, Atul; Hardin, C Corey; Hibbert, Kathryn A.
  • Wolf M; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Alladina J; Harvard Medical School, Boston, Massachusetts, USA.
  • Navarrete-Welton A; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Shoults B; Harvard Medical School, Boston, Massachusetts, USA.
  • Brait K; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Ziehr D; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Malhotra A; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Hardin CC; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Hibbert KA; Harvard Medical School, Boston, Massachusetts, USA.
Obesity (Silver Spring) ; 29(5): 870-878, 2021 05.
Article in English | MEDLINE | ID: covidwho-1059411
Semantic information from SemMedBD (by NLM)
1. Critical Illness COEXISTS_WITH COVID-19
Subject
Critical Illness
Predicate
COEXISTS_WITH
Object
COVID-19
2. Obesity COEXISTS_WITH COVID-19
Subject
Obesity
Predicate
COEXISTS_WITH
Object
COVID-19
3. risk factors COEXISTS_WITH COVID-19
Subject
risk factors
Predicate
COEXISTS_WITH
Object
COVID-19
4. Critical Illness PROCESS_OF Cohort
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Cohort
5. Obesity PROCESS_OF Cohort
Subject
Obesity
Predicate
PROCESS_OF
Object
Cohort
6. Obesity PROCESS_OF Patients
Subject
Obesity
Predicate
PROCESS_OF
Object
Patients
7. Increased ferritin NEG_PROCESS_OF Patients
Subject
Increased ferritin
Predicate
NEG_PROCESS_OF
Object
Patients
8. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
9. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
10. Critical Illness COEXISTS_WITH COVID-19
Subject
Critical Illness
Predicate
COEXISTS_WITH
Object
COVID-19
11. Obesity COEXISTS_WITH COVID-19
Subject
Obesity
Predicate
COEXISTS_WITH
Object
COVID-19
12. risk factors COEXISTS_WITH COVID-19
Subject
risk factors
Predicate
COEXISTS_WITH
Object
COVID-19
13. Critical Illness PROCESS_OF Cohort
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Cohort
14. Obesity PROCESS_OF Cohort
Subject
Obesity
Predicate
PROCESS_OF
Object
Cohort
15. Obesity PROCESS_OF Patients
Subject
Obesity
Predicate
PROCESS_OF
Object
Patients
16. Increased ferritin NEG_PROCESS_OF Patients
Subject
Increased ferritin
Predicate
NEG_PROCESS_OF
Object
Patients
17. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
18. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

OBJECTIVE:

Recent cohort studies have identified obesity as a risk factor for poor outcomes in coronavirus disease 2019 (COVID-19). To further explore the relationship between obesity and critical illness in COVID-19, the association of BMI with baseline demographic and intensive care unit (ICU) parameters, laboratory values, and outcomes in a critically ill patient cohort was examined.

METHODS:

In this retrospective study, the first 277 consecutive patients admitted to Massachusetts General Hospital ICUs with laboratory-confirmed COVID-19 were examined. BMI class, initial ICU laboratory values, physiologic characteristics including gas exchange and ventilatory mechanics, and ICU interventions as clinically available were measured. Mortality, length of ICU admission, and duration of mechanical ventilation were also measured.

RESULTS:

There was no difference found in respiratory system compliance or oxygenation between patients with and without obesity. Patients without obesity had higher initial ferritin and D-dimer levels than patients with obesity. Standard acute respiratory distress syndrome management, including prone ventilation, was equally distributed between BMI groups. There was no difference found in outcomes between BMI groups, including 30- and 60-day mortality and duration of mechanical ventilation.

CONCLUSIONS:

In this cohort of critically ill patients with COVID-19, obesity was not associated with meaningful differences in respiratory physiology, inflammatory profile, or clinical outcomes.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Body Mass Index / COVID-19 / Obesity Type of study: Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Obesity (Silver Spring) Journal subject: Nutritional Sciences / Physiology / Metabolism Year: 2021 Document Type: Article Affiliation country: Oby.23142

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Body Mass Index / COVID-19 / Obesity Type of study: Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Obesity (Silver Spring) Journal subject: Nutritional Sciences / Physiology / Metabolism Year: 2021 Document Type: Article Affiliation country: Oby.23142